RECRUITMENT OF A FIRM TO PROVIDE TECHNICAL SUPPORT TO THE HEALTH MANAGEMENT AND FINANCING SYSTEM AND

SELECTION OF CONSULTING FIRMS BY THE WORLD BANK GROUP REQUEST FOR EXPRESSION OF INTEREST (EOI) Electronic Submissions through WBGeProcure RFx Now ASSIGNMENT OVERVIEW Assignment Title: RECRUITMENT OF A FIRM TO PROVIDE TECHNICAL SUPPORT TO THE HEALTH MANAGEMENT AND FINANCING SYSTEM AND Assignment Countries: Guinea-Bissau ASSIGNMENT DESCRIPTION Terms of Reference— Technical Assistance to Strengthen Public Financial Management in the HealthSector of Guinea-Bissau (Consulting Firm) Two-phaselump-sum contract — Phase 1 (FY27) and conditional Phase 2 (FY28) 1. Background 1.1 Country and sectorcontext Guinea-Bissau is a fragile, low-income state with recurrentpolitical instability, a narrow fiscal base and governance indicators below theIDA fragility threshold. Despite notable progress against HIV, tuberculosis(TB) and malaria, the health system remains chronically underfunded and highlydependent on external financing and on household payments. Per capita generalgovernment health expenditure was about USD 5.20 in 2020, far below the USD 86benchmark, and out-of-pocket payments account for about 65–66 percent ofcurrent health expenditure. Health absorbed only 2.72 percent of generalgovernment expenditure in 2019, below regional peers such as Chad (5.23percent), Guinea (6.15 percent), Mauritania (6.98 percent), Niger (9.38percent) and Burkina Faso (9.58 percent). Externally funded vertical programmes for HIV, TB, malariaand immunization have their own management units and greater financial capacitythan the rest of the system. Government co-financing commitments to theseprogrammes cannot currently be traced through national systems. At the sametime, the irregular payment of health worker salaries has triggered recurrentstrikes that disrupt service delivery, underlining the cost of weak budgetexecution and payroll management for the population. 1.2 Public financialmanagement in the health sector: the problem this assignment addresses The WHO Health Financing Progress Matrix (HFPM) countryassessment for Guinea-Bissau (2025) rates public financial management (PFM) inthe health sector as “Emerging”. Its main findings are summarized below. Budgetplanning, execution, monitoring and reporting functions in the health sectorperform only in a limited way, within weak overall PFM systems. TheMinistry of Health does not produce financial execution data; budget executionreporting for the sector is not available and is not published. Allocationsfollow historical budgets and liquidity constraints, so policy priorities(including primary health care and HIV, TB and malaria) are poorly reflected inthe budget. Reallocation is possible within, but not between, current,personnel and investment lines, creating rigidity and delays. Healthfacilities rely heavily on self-generated user-fee revenue, managedautonomously with limited accountability, reporting and control atdecentralized levels. Limitedoversight of spending, including personnel spending, constrains fiscal spacefor critical expenditure. WHO recommends strengthening budgeting as the foundation forpolicy-driven planning that links all funding sources (State budget, externalfunds and user fees) to priorities; reinforcing the financial managementregulatory framework; and producing budget execution reports with fullinformation on funding sources and on expenditure by level, region, andinstitutional and economic classification. 1.3 The Global Fund–WorldBank engagement and how this assignment fits The Global Fund and the World Bank are supporting theGovernment of Guinea-Bissau to strengthen health financing and PFM in thehealth sector, with a focus on HIV, TB, malaria and Resilient and SustainableSystems for Health (RSSH). The support is financed by the Global Fund through atrust fund administered by the World Bank and is implemented in closecoordination with the Ministry of Health (MoH), the Ministry of Finance (MoF)and partners, notably WHO and the European Union (EU). This assignment covers the operational PFM component:accounting and financial management practices, budget monitoring andexpenditure tracking, financial reporting, and the related capacity building,at central level and in two pilot regions. 2. Objectives of the assignment Overall objective Strengthen the capacity of the MoH, in coordination with the MoF, torecord, monitor and report on health spending, from budget allocation toexecution, so that resources, including those for HIV, TB, malaria and RSSH andgovernment co-financing, are traceable, reported regularly and used fordecision-making. Specific objectives The firm is responsible for 3 specific objectives. First, Supportthe Rollout of a Financial Management System. Second, develop budget monitoringand expenditure-tracking processes and tools. Third, PFM Capacity Building for MoHand MoF Personnel with transfer skills to Ministry of Health and Ministry ofFinance staff 3. Phasing and contracting envelope The assignment is contracted in two phases. Phase 2 is a conditiona